GIBSONBURG HIGH CLASS OF 2018 GENERAL SCHOLARSHIP FORM COVER PAGE
Must be returned to Guidance Office by NOON on MARCH, 14, 2018.
ALL INFORMATION MUST BE TYPED – Submit BOTH pages 1 & 2, plus ALL additional requirements.
Applicant___________________________________Parent(s)/Guardian(s)________________________________
Address__________________________________________________________________________________________
To what college(s) have you applied? ____________________________________________________________
__________________________________________________________________________________________________
What is your intended college major? _____________________________________________________________
INSTRUCTIONS for Scholarships described in Section 1 of Guidelines, including:
All seven Gibsonburg Educational Foundation Scholarship Awards
The Dr. R. Allen and Helen B. Eyestone Scholarships
The Gibsonburg Athletic Boosters Scholarships
The Gibsonburg Teachers’ Association Scholarship
Madison Township-Gibsonburg Volunteer Fire Department Scholarship
In order to be considered for the scholarship programs above, YOU MUST TURN IN ALL 4
PAGES described below:
1) Page (this page) with all of your identifying information TYPED.
2) Page with YOUR NAME TYPED IN THE BLANK. If you are eligible for the
Athletic Boosters and/or the Teachers’ Association Scholarship(s), make sure to WRITE a check
in the blank to the left and write sports and varsity letters in blank for Athletic Boosters.
3) A separate one-page TYPED document with your name, typed & centered, at the top. On this
page, please also type the 3 headings specified below, and list all your activities/awards
under the appropriate headings:
Community Service/Volunteer Activities
Awards (Both Academic & Athletic, including varsity letters)
School-Sponsored AND Non-School Sponsored Activities, including Jobs
4) Another separate page, on which you respond to TWO of the four questions listed on page 2 of
this document.
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Applicant Name __________________________
INSTRUCTIONS for Scholarships described in Section 1 of Guidelines (cont.)
Essay Topic Choices (Pick TWO of these four choices and follow the “Specific
Directions for Responding to Essay Questions,” described below.)
Choice #1: What stimulated your interest in college, and what attributes do you possess that you feel will enhance your career?
Choice #2: What are your most important extracurricular or community activities? What made you join these activities? What made you continue to contribute to them?
Choice # 3: What was your most difficult time in life and why? How did your perspective on life
and/or on yourself change as a result of the difficulty?
Choice # 4: Discuss some issue of personal, local, national, or international concern and its
importance to you.
Specific Directions for Responding to Essay Questions:
TYPE YOUR NAME AT THE TOP OF THE PAGE.
If you choose to respond to Choice 1, type “Choice 1”, then type a 1-2 paragraph
response (at least 7 sentences/paragraph) to the question. Follow the same procedure
with your second essay choice.
Limit the TOTAL LENGTH (for both questions combined) to one page. (Be sure to label
each of your responses with the Choice # before responding.)
PLEASE PLACE AN X IN THE APPROPIATE BLANK(S) if you qualify for either of the scholarships
below. These two scholarships have NO additional application requirements:
_______Gibsonburg Athletic Boosters Scholarships. Please indicate below the sport(s) in which
you have earned varsity letters and the number of letters per sport:
_______ Gibsonburg Teachers’ Association Scholarships (Must be a Future Education Major)
IMPORTANT NOTE: In order to be considered for scholarships listed on pages
1& 2 of this application, you MUST TURN IN PAGE 1&2, as well as page with Activities/
Service/Awards AND a separate page with your responses to TWO of the Essay Topics
given – four pages total. On Page 3, place a CHECK next to any scholarships for which
you want to be considered, and follow the directions given for any additional
requirements.
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Applicant Name __________________________
GIBSONBURG HIGH CLASS OF 2018
SPECIAL CONSIDERATION SCHOLARSHIPS WITH ADDITIONAL APPLICATION REQUIREMENTS (Described in Section 2 of Guidelines)
Please PLACE A CHECK NEXT TO any of the special consideration scholarships below for
which you plan to submit the required ADDITIONAL APPLICATION REQUIREMENTS.
IMPORTANT NOTE: You must submit ALL requirements described below to be considered for these scholarships.
Place an X next to scholarships listed below for which you have completed the additional essay
requirements:
______Kay Kohler Family Scholarship- Complete all directions listed on Page 1 of this application AND
attach an additional one-page TYPED document, with your name, as well as “Kay Kohler
Family Scholarship” typed & centered at the top.
In this essay, discuss your aptitude and involvement in the arts (May include Visual, Dramatic
Performance, or Musical Performance)
______ James “Moe” Hoy Memorial Scholarship- Complete all parts of this application form AND
attach an additional TYPED essay, with your name, as well as “James “Moe” Hoy Memorial
Scholarship” typed & centered at the top.
In this essay, state your commitment to conservation and preserving our country’s hunting and
trapping heritage.
______ Food, Nutrition, and Culinary Science Scholarship- Complete all parts of this application form
AND attach an additional TYPED essay, with your name, as well as “Culinary Arts Scholarship”
typed & centered at the top.
In this essay, explain your aptitude for and desire to pursue a career in your field of study.
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Applicant Name __________________________
GIBSONBURG HIGH CLASS OF 2018
SPECIAL CONSIDERATION SCHOLARSHIPS WITH SEPARATE APPLICATIONS (Described in Section 3 of Guidelines)
Please PLACE A CHECK NEXT TO any of the special consideration scholarships below for
which you plan to submit the separate application (found at the end of this document).
IMPORTANT NOTE: You must submit ALL requirements described below to be considered for these scholarships.
Place an X next to scholarships listed below for which you have completed the additional
application:
______Hilfiker Elementary Parents (HEP) Scholarships (See enrollment requirement in
Guidelines document - section 2 of Guidelines for Local Scholarships.)
Complete separate application, HANDWRITTEN
(HEP scholarship application is Addendum #1 to this document.)
______Gibsonburg Fine Arts Boosters Scholarships
Complete separate application, typed or neatly handwritten in ink.
(Fine Arts Scholarship application is Addendum #3 to this document.)
______Sean Lutzmann Memorial Scholarship
Complete separate application, typed or neatly handwritten in ink.
(Sean Lutzmann Memorial Scholarship application is Addendum #2 to this document.)
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Addendum #1: Complete this form to be considered for the HEP Scholarship.
Hilfiker Elementary Parents (HEP) Scholarship Cover Page
Dear Scholarship Applicant,
Please give thoughtful, detailed responses to the following questions, including specific
examples wherever possible. We request that you complete EACH question, as incomplete
forms will not be considered. We also ask that your responses be HANDWRITTEN on another
piece/s of paper with this form stapled to the top. Remember that NEATNESS, AS WELL AS
CORRECT GRAMMAR AND PUNCTUATION COUNTS. It is highly suggested that you
have your responses proofread before submitting your application.
Gender: Male ________ Female _______
Years you were a student at Hilfiker Elementary _________________________
Question #1: During your time at Hilfiker Elementary there may have been several individuals
(teachers, support staff, volunteers, etc.) that had an impact on the quality of education you
received. Think of ONE such individual and explain in detail specifically HOW that person
made an impact on you and your education.
Question #2: Think of ONE skill you have today that was developed and encouraged during
your time at Hilfiker Elementary. Name that skill and explain specifically HOW that skill was
developed through the assistance of teachers, support staff, or volunteers.
Question #3: Name a significant event that happened to you at Hilfiker Elementary, and
explain how it impacted you.
Question #4: What course of study are you planning to take in college? Explain in what way/s
your experiences at Hilfiker Elementary influenced and helped you choose your course of
study.
Question #5: List any honors you have received over the past three years.
Question #6: List any extracurricular activities you have participated in over the past three
years. Please include the name of the organization or activity and the dates of your
involvement.
RETURN TO GUIDANCE
OFFICE BY NOON ON
WEDNESDAY, MARCH 14th
.
APPLICANT’S NAME _____________________________________
Addendum #2: Print and complete following pages for the FINE ARTS Scholarship.
GIBSONBURG FINE ARTS BOOSTERS (GFAB)
SCHOLARSHIPS APPLICATIONS 2018
Herbert & Edith Bell Scholarships: 6 totaling $1,000.00
Fine Arts Boosters Music Major Scholarship: $500
Eligibility: Any senior who has been involved with the Gibsonburg Music Department
during high school is welcome to apply for the Bell Scholarships; those students planning a
degree in music may apply for the GFAB Music Major Scholarship. Scholarships are awarded
based upon points accrued for Fine Arts, School, and Community activities.
Applications: Will be available from the Band & Choir Directors and in the Guidance
Office starting February 16, 2018 and MUST be completed and turned in by March 9th
, 2018.
NO LATE ENTRIES WILL BE ACCEPTED
Please Note: Only include information /activities from High School Years on the
application. There is additional section for Music Major Applicants.
Selection Committee: Will consist of the Executive Committee of GFAB , the Band &
Choir Directors, and one parent of an underclassman & one outside community member.
Awarded Scholarships: Each student may be awarded only ONE scholarship given by
Gibsonburg Fine Arts Boosters. Music Major Applicants not receiving this award will
automatically be included for the Bell Scholarships. All Scholarships will be announced at the Annual Fine Arts Banquet in the spring.
Payment of Scholarships: Herbert & Edith Bell Scholarship recipients must present a
bursar’s statement to the GFAB for reimbursement. Music Major Scholarship recipient must
present a copy of 1st semester grades showing a GPA of 2.5 or above for reimbursement.
Thank you for applying and Good Luck!
Gibsonburg Fine Arts Boosters
GIBSONBURG FINE ARTS BOOSTERS SCHOLARSHIP APPLICATION 2018 1
Part 1 – General Information Verified by _____________________________
Years in Music Department _____ ________________________ Verified by _____________________________
Student Full Name ___________________________________________________________________________
Street Address ______________________________________________________________________________
City ____________________________________________________ Ohio Zip Code _____________________
Contact Number ___________________________________________ Email ____________________________
Parent/Guardian ____________________________________________________________________________
Phone # / Address if different from above _________________________________________________________
Parent/Guardian ____________________________________________________________________________
Phone # / Address if different from above _________________________________________________________
At what school to you plant to continue your education?
__________________________________________________________________________________________
Major / Field of Study
__________________________________________________________________________________________
__________________________________________________________________________________________
GIBSONBURG FINE ARTS BOOSTERS SCHOLARSHIP APPLICATION 2018 2 Part II – Music Participation
Music Classroom Participation (including independent study)
Band # of Years Points Total
Concert Band _______________________________________________________ 40 _____
Jazz Band __________________________________________________________ 40 _____
Choir # of Years Points Total
Mixed Glee _________________________________________________________ 40 _____
Show Choir _________________________________________________________ 40 _____
Women’s Choir ______________________________________________________ 40 _____
Out of Classroom Participation
Band # of Years Points Total
Marching Band ______________________________________________________ 20 _____
Pep Band __________________________________________________________ 20 _____
Honors Band _______________________________________________________ 15 _____
All State Band_______________________________________________________ 20 _____
Ohio State Fair Band _________________________________________________ 20 _____
Choir # of Years Points Total
Jazz Choir .................................................................................................................... 20 _____
Honors Choir ................................................................................................................ 15 _____
All State Choir .............................................................................................................. 20 _____
Band & Choir # of years Points Total
Auxiliary Band (Majorette/Flag Corps etc .................................................................... 15 _____
School Musical ............................................................................................................. 15 _____
Band/Choir Section Leader .......................................................................................... 10 _____
Band/Choir Officer ........................................................................................................ 10 _____
Private Lessons (with verification)................................................................................ 10 _____
Community Musical (with verification) .......................................................................... 10 _____
GIBSONBURG FINE ARTS BOOSTERS SCHOLARSHIP APPLICATION 2018 3
Part III – Solo & Ensemble Competitions (Score 2-Fair, 4-Good, 6-Excellent, 8-Superior)
Competition / Event Date Points
1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
3. ________________________________________________________________________________________
4. ________________________________________________________________________________________
5. ________________________________________________________________________________________
6. ________________________________________________________________________________________
7. ________________________________________________________________________________________
8. ________________________________________________________________________________________
9. ________________________________________________________________________________________
10. _______________________________________________________________________________________
11. _______________________________________________________________________________________
12. _______________________________________________________________________________________
13. _______________________________________________________________________________________
14. _______________________________________________________________________________________
15. _______________________________________________________________________________________
TOTAL __________
Part III – Large Group Competitions (Score: 10 pts for each)
1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
3. ________________________________________________________________________________________
4. ________________________________________________________________________________________
5. ________________________________________________________________________________________
6. ________________________________________________________________________________________
7. ________________________________________________________________________________________
8. ________________________________________________________________________________________
9. ________________________________________________________________________________________
10. _______________________________________________________________________________________
11. _______________________________________________________________________________________
12. _______________________________________________________________________________________
13. _______________________________________________________________________________________
14. _______________________________________________________________________________________
15. _______________________________________________________________________________________
TOTAL __________
GIBSONBURG FINE ARTS BOOSTERS SCHOLARSHIP APPLICATION 2018 4
Part IV – Community Service & Citizenship
Youth/Community Group # of years Points Total
1. ______________________________________________________________ 15 _____
2. ______________________________________________________________ 15 _____
3. ______________________________________________________________ 15 _____
4. ______________________________________________________________ 15 _____
5. ______________________________________________________________ 15 _____
6. ______________________________________________________________ 15 _____
7. ______________________________________________________________ 15 _____
8. ______________________________________________________________ 15 _____
9. ______________________________________________________________ 15 _____
10. _____________________________________________________________ 15 _____
Part V – School Activities (please list each sport…baseball, basketball for example, per year/ line below)
Freshman __________________________________________________________________________________
Sophmore __________________________________________________________________________________
Junior _____________________________________________________________________________________
Senior _____________________________________________________________________________________
School Organizations/Clubs # of years Points Total
1. ______________________________________________________________ 5 _____
2. ______________________________________________________________ 5 _____
3. ______________________________________________________________ 5 _____
4. ______________________________________________________________ 5 _____
5. ______________________________________________________________ 5 _____
6. ______________________________________________________________ 5 _____
7. ______________________________________________________________ 5 _____
8. ______________________________________________________________ 5 _____
9. ______________________________________________________________ 5 _____
10. _____________________________________________________________ 5 _____
GIBSONBURG FINE ARTS BOOSTERS SCHOLARSHIP APPLICATION 2018 5
Part VI – Academic Achievement – high school years only
# of Quarters Points Total
High Honor Roll ___________________________________________________ 5 _____
Honor Roll _______________________________________________________ 3 _____
Part VII – Other Fine Arts Related Considerations
Please list any activities NOT PREVIOUSLY LISTED – points will be determined by the Scholarship Committee, Maximum points: 50
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
The information presented in this application is true and accurate. If any statement is proved false I will withdraw from the Gibsonburg Fine Arts Scholarship competition.
Name (Print) _______________________________________________________________________
Signature __________________________________________________________________________
Date ________________________________________
GIBSONBURG FINE ARTS BOOSTERS SCHOLARSHIP APPLICATION 2018 6
MUSIC MAJOR SCHOLARSHIP PAGE
If you are attending college to pursuing a career in music, you are eligible for the Gibsonburg Music Major Scholarship; applicants NOT pursuing a career in music need not apply.
Check all applicable categories per school year: 10 pts each
6th 7th 8th Total
Fine Arts Participations in Grades 6-8
Band _________________________________________________________________________
Choir _________________________________________________________________________
School Musicals _________________________________________________________________
Solo & Ensemble Competition ______________________________________________________
Please submit a 500 word essay stating why you wish to pursue a career in music.
SEAN LUTZMANN MEMORIAL SCHOLARSHIP
GENERAL INFORMATION
PURPOSE: This scholarship is to honor the memory of Sean Andrew Lutzmann. Education was very important to Sean and remains so to his family. Sean was proud to be a 2006 graduate of Gibsonburg High School where he enjoyed every minute of his high school career. Sean played football, participated in track & field, was a class officer and on the student council, along with many other activities. He received a full tuition & fees scholarship to Bowling Green State University where he was a writer for the BG News and a Senator in the Undergraduate Student Government; he graduated with a degree in Political Science & History in 2010. Sean loved life, he lived every day to make the world a better place and touched many lives as a result of that effort; his friendship and support were never predicated on age, race, gender, political or religious affiliation, location or social status. The only thing Sean truly disliked was apathy.
ELIGIBILITY: Applicants must be graduating seniors and must have been accepted by a college or university. This application is open to all students, but a preference will be given to students that participated in Student Council and exhibit Community Involvement.
APPLICATIONS: Applications will be kept in the Superintendent’s Office. Completed applications must be returned to the Guidance’s Office by Noon on March 14, 2018
SELECTIONCOMMITTEE: A 6 member selection committee shall consist of 2 family members and 4 representatives
from Gibsonburg Schools.
SELECTION: Criteria to be considered are scholastic ability, positive leadership, and community involvement in the tradition of Sean Lutzmann.
THIS IS A RENEWABLE SCHOLARSHIP. APPLICANTS WILL BE REQUIRED TORE-APPLY EACH YEAR.
SEAN LUTZMANN MEMORIAL SCHOLARSHIP APPLICATION
NAME: CLASS OF:
ADDRESS: PHONE:
PARENTS:
NAME (S) OF COLLEGES/UNIVERSITIES ACCEPTED BY:
PLEASE GIVE US A SHORT WRITING RESPONSE ABOUT HOW THE COMMUNITY OF GIBSONBURG HAS AFFECTED YOUR LIFE OR PLAYED A ROLE IN INFLUENCING YOUR LIFE. PLACE THIS RESPONSE ON THE BACK OF THIS FORM!
PLEASE LIST ANY NOTEWORTHY ACHIEVEMENTS, AWARDS, OR POSITIONS HELD IN THE AREAS BELOW:
ACADEMICS:
ATHLETICS:
LEADERSHIP:
COMMUNITY INVOLVEMENT:
PLEASE INCLUDE 2 LETTERS OF REFERENCE FROM NON-FAMILY MEMBER (I.E. – TEACHER, ADMINISTRATOR, CLERGY, ETC.)